title: The effect of intravitreal bevacizumab (Avastin) on ocular pulse amplitude in neovascular age-related macular degeneration.
abstract: OBJECTIVE
  To evaluate the effect of intravitreal (IVT) bevacizumab in neovascular age-related macular degeneration (AMD) on global choroidal hemodynamics, as measured by ocular pulse amplitude (OPA).
  
  
  METHODS
  This was a two-center prospective study (Sheba Medical Center, Israel, and University Hospitals Leuven, Belgium). AMD patients who required IVT bevacizumab (1.25 mg/0.05 mL; first or repeated) were examined three times: at days 0 (prior to injection), 7 (±3), and 28 (±7) postinjection. At each visit, OPAs of both eyes were measured using the Pascal dynamic contour tonometer (DCT). A paired t-test between preoperative and postoperative OPA was conducted. Pearson correlation was used to evaluate the influence of various measured parameters on DCT-OPA.
  
  
  RESULTS
  A total of 38 neovascular AMD patients were recruited, and 30 patients were included in the final analysis (18 females and 12 males; age 78.8 ± 5.82 years [mean ± standard deviation]). A good correlation was found throughout the study between the DCT-intraocular pressure (IOP) and Goldmann IOP and between DCT-IOP and DCT-OPA. No change in OPA of bevacizumab-treated eyes was found between the visits (2.24 ± 0.73, 2.2 ± 0.86, and 2.23 ± 0.73 mm Hg at visits 1, 2, and 3, respectively; paired t-test: P = 0.77 between visits 1 and 2, P = 0.98 between visits 1 and 3). No correlations were found between DCT-OPA and age, heart rate, systemic blood pressure, axial length, keratometry readings, and central corneal thickness.
  
  
  CONCLUSIONS
  OPA, an indirect measure of global choroidal hemodynamics, remains unchanged following IVT off-label bevacizumab. This finding adds to the growing evidence regarding the safety profile of bevacizumab in AMD treatment.
authors.affiliation: Goldschleger Eye Institute, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Ehud
authors.initials: E
authors.lastname: Rechtman
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Stalmans
authors.forename: Joseph
authors.initials: J
authors.lastname: Glovinsky
authors.forename: Christophe
authors.initials: C
authors.lastname: Breusegem
authors.forename: Joseph
authors.initials: J
authors.lastname: Moisseiev
authors.forename: Joachim
authors.initials: J
authors.lastname: Van Calster
authors.forename: Alon
authors.initials: A
authors.lastname: Harris